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BackgroundMajor depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes. ObjectiveA systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2). MethodsTwo specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review. ResultsThe 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes with most trials using self-report data. Studies varied significantly in presentation of intervention content, treatment dose, and dropout. Only two studies included moderator or clinician input. Results for Section 2 were less consistent. None of the Section 2 studies reported controlled or randomized designs. With the exception of four studies, all included participants were younger than 25 years of age. Eight of the 16 social networking studies reported positive results for depression-related outcomes. The remaining studies were either mixed or negative. Findings for online support groups tended to be more positive; however, noteworthy risks were identified. ConclusionsOnline interventions with a broad cognitive behavioral focus appear to be promising in reducing depression symptomology in young people. Further research is required into the effectiveness of online interventions delivering cognitive behavioral subcomponents, such as problem-solving therapy. Evidence for the use of social networking is less compelling, although limited by a lack of well-designed studies and social networking interventions. A range of future social networking therapeutic opportunities are highlighted.

Men have been underrepresented in research investigating the pathway from social anxiety through loneliness to suicidality. The present study examined loneliness as a mediator between social anxiety and suicidality among men, along with exposure to childhood trauma as a moderator of this pathway. A nationally representative sample of 530 Canadian men completed study measures online. Bootstrapped tests of indirect effects indicated loneliness to be a significant mediator after controlling for depression symptoms, and this mediation effect was moderated by exposure to multiple types of childhood trauma. The link between social anxiety and loneliness--and the mediating effect of loneliness on suicidality--was strongest among men reporting two or more types of childhood trauma. Efforts to mitigate men's suicidality in the context of social anxiety may benefit from targeting loneliness, with particular attention to the effects of childhood trauma., Author(s): David Kealy [sup.1] , Simon M. Rice [sup.2] [sup.3] , Zac E. Seidler [sup.2] [sup.3] , John S. Ogrodniczuk [sup.1] , John L. Oliffe [sup.4] [sup.5] Author Affiliations: (1) [...]

This cross-sectional study explored athlete responses to the Compassion Motivation and Action Scales Self-Compassion Scale, examining its relationship with well-being. Athlete (N = 207; mean age 27.9 years) scores were consistent with previous population means. Scores on the Compassion Motivation and Action Scales Self-Compassion Scale did not differ between elite and nonelite athletes, nor did they correlate significantly with trait competitiveness. Significant differences emerged based on athlete well-being state, with athletes categorized as "flourishing" scoring higher on the total score and all subscales of the Compassion Motivation and Action Scales Self-Compassion Scale, as compared with those with "moderate mental health" (Cohen's ds from 0.58 to 0.92). Furthermore, the distress tolerance subscale significantly mediated the relationship between self-compassion intentions and well-being (indirect path: B = 0.034, p <.001). The results suggest that self-compassionate intentions are not enough, and athletes may need support to tolerate the distress that comes with moving toward one's own suffering. [ABSTRACT FROM AUTHOR]

Aim: Lithium, even at low doses, appears to offer neuroprotection against a wide variety of insults. In this controlled pilot, we examined the safety (i.e., side‐effect profile) of lithium in a sample of young people identified at ultra‐high risk (UHR) for psychosis. The secondary aim was to explore whether lithium provided a signal of clinical efficacy in reducing transition to psychosis compared with treatment as usual (TAU). Methods: Young people attending the PACE clinic at Orygen, Melbourne, were prescribed a fixed dose (450 mg) of lithium (n = 25) or received TAU (n = 78). The primary outcome examined side‐effects, with transition to psychosis, functioning and measures of psychopathology assessed as secondary outcomes. Results: Participants in both groups were functionally compromised (lithium group GAF = 56.6; monitoring group GAF = 56.9). Side‐effect assessment indicated that lithium was well‐tolerated. 64% (n = 16) of participants in the lithium group were lithium‐adherent to week 12. Few cases transitioned to psychosis across the study period; lithium group 4% (n = 1); monitoring group 7.7% (n = 6). There was no difference in time to transition to psychosis between the groups. No group differences were observed in other functioning and symptom domains, although all outcomes improved over time. Conclusions: With a side‐effect profile either comparable to, or better than UHR antipsychotic trials, lithium might be explored for further research with UHR young people. A definitive larger trial is needed to determine the efficacy of lithium in this cohort. [ABSTRACT FROM AUTHOR]

Context: The international sports community is becoming more proactive in clinical mental health practice and research. An athlete-specific psychological distress screening tool can identify potential mental health illness. Design: The Athlete Psychological Strain Questionnaire (APSQ) is a simple screening tool for detecting early signs of athlete-specific strain and related mental health concerns. Methods: We evaluated the internal consistency and reliability of the translated and culturally adjusted Arabic version of the APSQ (APSQ-Ar) with Arabic-speaking elite athletes. The final translation underwent standard forward and backward translation, an inspection by a team of experts, and then preliminary testing. The APSQ-Ar was cross-culturally validated and then assessed for internal consistency and reliability among (n = 98) Arabic-speaking athletes. Results: There were no problems with the patients' understanding or interpretation of the items on the APSQ-Ar translation. The intraclass correlation value was.93 (95% confidence interval,.89–.95), and the mean difference was 2.4 with a minimal detectable change of 5.12, demonstrating strong test–retest reliability. Moreover, Cronbach alpha showed excellent internal consistency (.76). Conclusions: The APSQ-Ar was demonstrated to be good, reliable, and internally consistent. With APSQ-Ar, sports medicine professionals in Arabic-speaking countries will be able to identify psychological distress and symptoms in athletes and, as a result, provide them with mental health support. [ABSTRACT FROM AUTHOR]

Organised sport is a widely accessible context that can promote health and health behaviours among participants. For that reason, recent decades have brought forth a number of sport-based interventions aimed at improving mental health literacy and symptoms. Despite this trend, there has yet to be a systematic review and meta-analysis to synthesise and estimate the efficacy of published sport-based intervention studies in non-elite sport. Following a systematic search of the literature, we conducted seven independent meta-analyses to test the effect of sport-based interventions on mental health outcomes (depression, anxiety, psychological distress, and wellbeing) and mental health literacy (stigmatising attitudes, knowledge of mental health, and help-provision). A total of 19 articles reporting 47 distinct effect sizes revealed moderate to strong favourable effects of interventions on stigmatising attitudes, knowledge of mental health, and help-provision. Small favourable effects were detected for anxiety, psychological distress, and wellbeing. Finally, sport-based interventions had no significant synthesised effect on depressive symptoms. Although we comment on the need for stronger intervention designs, the field can be optimistic with respect to the mental health literacy findings from the current study and their potential downstream effects on mental health symptoms. [ABSTRACT FROM AUTHOR]